MEDICARE: REGINA PLOHAL FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	116288	OK
2	363L00000X	Nurse Practitioner	5011197	NC

General Provider Information

NPI Number	:	1932637634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA PLOHAL FNP

Provider Business Mailing Address
First Line	:	10210 HICKORYWOOD HILL AVE STE 200
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3417
Country	:	US
Telephone Number	:	704-931-3376
Fax Number	:	704-601-7808

Provider Business Practice Location Address
First Line	:	10210 HICKORYWOOD HILL AVE STE 200
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3417
Country	:	US
Telephone Number	:	704-931-3375
Fax Number	:	704-601-7808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2017
Last Update Date	:	08/12/2025

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